Raven S Horne
Individual provider Active NPI Licensed Practical Nurse · Enfield, CT
NPI 1497323893 · NPPES record last updated Jun 14, 2021
Key facts
- NPI
- 1497323893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 040861 (CT)
- Practice address
- 153 Hazard Ave
Enfield, CT 06082-4592 - Phone
- (860) 253-5020
- Fax
- (860) 731-5536
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040861 | CT | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Licensed Practical Nurse | 164W00000X | 040861 | CT | Yes |
Addresses
Primary practice location
153 Hazard Ave
Enfield, CT 06082-4592
Mailing address
2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522
Other providers in Enfield, CT
- Aikijah Holt
- Home for the Aged of the Little Sisters of the Poor Incorporated
- Hometown Health, LLC
- Elizabeth Honey
- Hope Forward Therapy LLC
- Timothy Huber
- Humair DME Solution
- Takima Hurst
- Morica Hutchinson
- Nekeisha Hutchinson
All providers in Enfield, CT · Licensed Practical Nurse in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.